Hip Dysplasia/ Developmental Dysplasia of Hip
The hip is a ball-and-socket joint. The “ball” is the rounded top of the thighbone (the femoral head); the socket; is a cup-shaped bone that the ball fits into (the acetabulum).
Developmental dysplasia of the hip (DDH) is a relatively common disorder of the hip joint that can affect a patients spanning from infancy(0-1) to adulthood(above 18). It is an abnormality of the hip joint where the socket portion does not fully cover the ball portion, resulting in an increased risk for joint dislocation and hip osteoarthritis at later stages of life. Development of DDH depends on the way an infants hip joint is formed before during or after birth.
In mild cases of DDH, the ball moves back and forth slightly in the socket, leading to an unstable hip. In moderate cases, the ball becomes dislocated and moves completely out of the socket. In severe cases, the ball may not even reach the socket where it could be held in place thereby causing trouble walking and making the hip joint vulnerable for hip dislocation. Complications without treatment can include arthritis, limping, and low back pain.
The exact cause of DDH is unknown, but it is considered to be a “multifactorial” meaning there are multiple factors involved:
- children with a family history of DDH in a first-degree relative
- females, because they have looser ligaments than males
- first-borns, who fit in the uterus tightly than in later borns
- foetus with breech presentations, whose constrained position in the womb tends to
strain the ligaments of the hip joint
Patients usually don’t present with any obvious signs and symptoms. To diagnose it, doctors look for these signs:
- an audible or palpable clunk; at birth or during routine newborn checkups
- different leg lengths
- asymmetry in the fat folds of the thigh around the groin or buttocks
- after 3 months, asymmetry in the motion of the hip and obvious shortening of the affected leg
- an exaggeration in the spinal curvature that may develop to compensate for the abnormally developed hip limping at later ages.
Management at AktivHealth :
During the physical examination, a doctor would determine whether a hip is dislocated or likely to become dislocated. The doctor may recommend an X-ray or an MRI/ ultrasound to get a better view of the affected hip joint. Depending upon the diagnosis and the severity of the condition treatment will include bracing weight loss, lifestyle modifications, joint injections, and specialized Aktivkids physical therapy program. For severe cases, surgical intervention and casting will be required along with pre and post-operative rehabilitation for early and optimal recovery.